Precertification and Authorization Rep-Remote

Mayo Clinic • Rochester, MN

2d • Remote

About The Position

The Precertification and Authorization Representative is an intermediate level position that is responsible for resolving referral, precertification, and/or prior authorization to support insurance specific plan requirements for all commercial, government and other payors across hospital (inpatient & outpatient), ED, and clinic/ambulatory environments. In addition, this position may be responsible for pre-appointment insurance review (PAIR) and denials recovery functions within the Patient Access department. This may include processing of pre-certification and prior authorization for workers compensation/third party liability (WC/TPL), managed care and HMO accounts, as well as working assigned registration denials for government and non-government accounts. This role requires adherence to quality assurance guidelines as well as established productivity standards to support the work unit’s performance expectations.

Requirements

• Intermediate level position
• Resolving referral, precertification, and/or prior authorization
• Support insurance specific plan requirements for all commercial, government and other payors
• Support hospital (inpatient & outpatient), ED, and clinic/ambulatory environments
• May be responsible for pre-appointment insurance review (PAIR)
• May be responsible for denials recovery functions within the Patient Access department
• Processing of pre-certification and prior authorization for workers compensation/third party liability (WC/TPL), managed care and HMO accounts
• Working assigned registration denials for government and non-government accounts
• Adherence to quality assurance guidelines
• Adherence to established productivity standards

Responsibilities

• Resolving referral, precertification, and/or prior authorization to support insurance specific plan requirements for all commercial, government and other payors across hospital (inpatient & outpatient), ED, and clinic/ambulatory environments.
• Processing of pre-certification and prior authorization for workers compensation/third party liability (WC/TPL), managed care and HMO accounts.
• Working assigned registration denials for government and non-government accounts.
• Adherence to quality assurance guidelines.
• Adherence to established productivity standards to support the work unit’s performance expectations.

Benefits

• Competitive compensation
• Comprehensive benefit plans
• Continuing education and advancement opportunities
• Medical: Multiple plan options.
• Dental: Delta Dental or reimbursement account for flexible coverage.
• Vision: Affordable plan with national network.
• Pre-Tax Savings: HSA and FSAs for eligible expenses.
• Retirement: Competitive retirement package to secure your future.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees